tag:blogger.com,1999:blog-7675087351939177300.post4915890762670317118..comments2014-07-06T19:04:39.657-05:00Comments on Sutured for a Living: Postop Hematomas in Plastic Surgeryrlbateshttp://www.blogger.com/profile/15236331355857884458noreply@blogger.comBlogger11125tag:blogger.com,1999:blog-7675087351939177300.post-5409240287280737452010-06-17T21:03:16.698-05:002010-06-17T21:03:16.698-05:00Thank you! Been searching internet for answer. M...Thank you! Been searching internet for answer. Much appreciated. Recovering from some plastic surgery, can&#39;t wait to go back and read your archives!Sarahhttp://www.blogger.com/profile/01219895604370083732noreply@blogger.comtag:blogger.com,1999:blog-7675087351939177300.post-32306138423125848552009-11-03T21:06:46.270-06:002009-11-03T21:06:46.270-06:00just following up on my contact infojust following up on my contact infoMariahttp://www.blogger.com/profile/15032989563232983199noreply@blogger.comtag:blogger.com,1999:blog-7675087351939177300.post-35704780127361497032009-11-03T21:05:21.653-06:002009-11-03T21:05:21.653-06:00I came accross this article while researching &quo...I came accross this article while researching &quot;post surgry hematoma.&quot; My mother had a double mastectomy followed by an immediate reconstruction (DIEP flap. Her abdominal wound suddenly began to open and is now open 13 cm and pretty deep. The doctor told us it is a hematoma. I found this article and it was very helpful since my mother&#39;s blood pressure became volatile at the onset of the surgery. The surgery was 18 hours (the last six of which were the result of trying to stablizie the BP) so the information here makes total sense to me. My mother is 5 weeks post-surgery and has a very aggressive cancer which needs intense chemo. I feel like we are racing against the clock since the oncologist does not want to start chemo with a wound that is getting progressively worse. This is very frustrating but atleast this has been very insightful. Incidentally, my mother has NEVER had a history of BP problems- always normal. A cardiologist speculated it might have been &quot;thyroid storm&quot; a whole other topic. Thank you!m schwartznoreply@blogger.comtag:blogger.com,1999:blog-7675087351939177300.post-60862605383928698112008-04-09T19:22:00.000-05:002008-04-09T19:22:00.000-05:00Carol A, I can't really diagnosis you without seei...Carol A, I can't really diagnosis you without seeing or touching. That said, maybe you should go back in and have him/her recheck it to be sure it isn't a localized hematoma. If not, then what?rlbateshttp://www.blogger.com/profile/15236331355857884458noreply@blogger.comtag:blogger.com,1999:blog-7675087351939177300.post-87656780093225925282008-04-09T17:57:00.000-05:002008-04-09T17:57:00.000-05:00i am an rn who had an s lift 2 wks ago. i was give...i am an rn who had an s lift 2 wks ago. i was given an antihypertensive med pre op.i have a goose egg type swelling on the r side of my face. my doc said its not a hematoma because its not expanding. however its not shrinking. any comments? thanks carol acarol ahttp://www.blogger.com/profile/05612333727091902443noreply@blogger.comtag:blogger.com,1999:blog-7675087351939177300.post-8460964747450414242008-01-05T08:59:00.000-06:002008-01-05T08:59:00.000-06:00Thanks Small Town Doc for your comment. SmTD, I d...Thanks Small Town Doc for your comment. SmTD, I don't think it's stupid, but not sure how practical. The "speed" of reversal will depend on which drugs are being used. The anesthesia folk I work with vary the mix depending on the procedure length, the procedure itself, and the patient (history of HBP, allergies, past side effects like nausea and vomiting, etc). It's just important for use to continue watch and learn.rlbateshttp://www.blogger.com/profile/15236331355857884458noreply@blogger.comtag:blogger.com,1999:blog-7675087351939177300.post-76284220031125911592008-01-04T21:40:00.000-06:002008-01-04T21:40:00.000-06:00Nice post. It is so interesting when one logical a...Nice post. It is so interesting when one logical action leads to an unexpected result, which again has a logical explanation. Hypotensive anesthesia- increased bleed due to capillaries opening up after closing the wound because of bp normalizing. Weird. Just n idea. What will happen if we maintain the bp upto just closing up in hypotension and just before closing, normalize the bp and catch-up the bleeders? Do you think that it is stupid or do anesthetist use long-acting anti-hypertensives? -smalltowndoc@wordpress.comsmalltowndochttp://www.blogger.com/profile/04320389819061356015noreply@blogger.comtag:blogger.com,1999:blog-7675087351939177300.post-90513233161153938762007-12-26T16:23:00.000-06:002007-12-26T16:23:00.000-06:00Happy to have your input Dr Sid.Happy to have your input Dr Sid.rlbateshttp://www.blogger.com/profile/15236331355857884458noreply@blogger.comtag:blogger.com,1999:blog-7675087351939177300.post-27395963909162665952007-12-26T16:14:00.000-06:002007-12-26T16:14:00.000-06:00Because there were a couple of anesthesia guys who...Because there were a couple of anesthesia guys who liked it, I did a couple of mastectomies under controlled hypotension. I never really liked it, for the reasons you mentioned: mainly, I worried that after awakening things would be more likely to bleed, for having been unnoticed during surgery. I never spilled much blood anyway during mastectomy -- never even ordered type and screen -- so I discouraged it after a couple of cases, even though there were no problems.Sid Schwabhttp://www.blogger.com/profile/14182853083503404098noreply@blogger.comtag:blogger.com,1999:blog-7675087351939177300.post-39413327032888637252007-12-26T09:10:00.000-06:002007-12-26T09:10:00.000-06:00Thanks Terry for your comment. I think it is impo...Thanks Terry for your comment. I think it is important to review the way we do things. Sometimes small (or large) changes can make a difference in outcome. I love it when we all work together.rlbateshttp://www.blogger.com/profile/15236331355857884458noreply@blogger.comtag:blogger.com,1999:blog-7675087351939177300.post-77285009517821970142007-12-26T09:07:00.000-06:002007-12-26T09:07:00.000-06:00Interesting post. As an anesthesia provider, I am ...Interesting post. As an anesthesia provider, I am glad to see that hypotensive anesthesia is being revisited in plastic surgery. Although it can and is delivered safely and effectively, I often wondered what happens to the poorly controlled hypertensive patient after the hypotensive anesthesia is over. This sounds like a much more inclusive purview of BP management.Terry at Counting Sheephttp://www.blogger.com/profile/16060732608278736543noreply@blogger.com